The effects of emotional stress as a factor in treatment outcome and morbidity in end-stage renal patients on hemodialysis is becoming an important issue. Samples were taken from patients on conventional hemodialysis pre-, during and post-treatment. These samples were analyzed by ultramicro immunochemical techniques for a series of inflammatory and immune regulatory factors (neuropeptides and cytokines). Additionally, markers of stress were also measured using affinity and immunoaffinity techniques. The results from the laboratory tests were compared to the gender and marital status of the patient. Married patients were also examined for relationship between emotional stress situations and response to treatment. The studies indicate that stressful home situations are most influential amongst women and appear to demonstrate some correlation with survival and response to treatment.